College of Health & Biomedicine, Victoria University, Melbourne, Australia.
Institute for Sport, Exercise and Active Living, Victoria University, Melbourne, Australia.
Health Qual Life Outcomes. 2017 Dec 21;15(1):245. doi: 10.1186/s12955-017-0826-2.
Limited health literacy is known to impact on medication adherence, hospital readmission and potentially poorer health outcomes. The literature on the health literacy of those with musculoskeletal conditions suggests greater functional limitations and increased pain levels. There are a number of measures of health literacy. One that specifically relates to musculoskeletal complaints is the Literacy in Musculoskeletal Problems (LiMP) questionnaire. The LiMP contains 9 multiple choice items that cover anatomy, musculoskeletal conditions and the diagnosis of musculoskeletal complaints. The aim of the study was to evaluate the dimensionality and internal structure of the LiMP in patients attending for osteopathy care at a student-led clinic, as a potential measure of musculoskeletal health literacy.
Three hundred and sixty-one (n = 361) new patients attending the Victoria University Osteopathy Clinic completed the LiMP and a demographic and health information questionnaire prior to their initial consultation. Mokken scale analysis, a nonparametric item response theory approach, was used to evaluate the dimensionality and structure of the LiMP in this population, to ascertain whether the questionnaire was measuring a single latent construct - musculoskeletal health literacy. McDonald's omega and Cronbach's alpha were calculated as the reliability estimations. The relationship between the LiMP and a single item screen of health literacy was also undertaken.
The 9 items on the LiMP did not form a Mokken scale and the reliability estimations were below an acceptable level (alpha and omega <0.45). LiMP items 5 and 8 were more likely to be answered correctly by those with higher health literacy (p < 0.05), however the effect sizes were small (<0.20).
Calculation of a total score for the LiMP, as advocated by the original authors, is not supported based on data in the present study. Further research is required to explore the relationship of the LiMP items to demographic and clinical data, and to other broader measures of health literacy. Further research may also develop a health literacy measure that is specific to patients seeking manual therapy care for musculoskeletal complaints.
有限的健康素养会影响药物治疗的依从性、住院再入院率，并可能导致更差的健康结果。患有肌肉骨骼疾病患者的健康素养文献表明，他们的功能限制更大，疼痛水平更高。有许多健康素养的衡量标准。专门针对肌肉骨骼疾病的是肌肉骨骼问题文化程度（LiMP）问卷。LiMP 包含 9 个多项选择题，涵盖解剖学、肌肉骨骼疾病和肌肉骨骼疾病的诊断。该研究的目的是评估在学生主导的诊所接受整骨治疗的患者中 LiMP 的维度和内部结构，作为肌肉骨骼健康素养的潜在衡量标准。
361 名（n=361）新患者在维多利亚大学整骨诊所就诊，在首次就诊前完成 LiMP 和人口统计学及健康信息问卷。Mokken 量表分析是一种非参数项目反应理论方法，用于评估该人群中 LiMP 的维度和结构，以确定问卷是否在测量单一潜在结构-肌肉骨骼健康素养。计算了 McDonald's omega 和 Cronbach's alpha 作为可靠性估计。还研究了 LiMP 与单一健康素养筛查项目之间的关系。
LiMP 的 9 个项目没有形成 Mokken 量表，可靠性估计值低于可接受水平（alpha 和 omega <0.45）。LiMP 项目 5 和 8 更有可能被健康素养较高的人正确回答（p<0.05），但效应大小较小（<0.20）。
根据本研究的数据，不支持原始作者提倡的 LiMP 总分计算方法。需要进一步研究来探讨 LiMP 项目与人口统计学和临床数据以及其他更广泛的健康素养衡量标准的关系。进一步的研究可能会开发出专门针对寻求针对肌肉骨骼疾病的手动治疗的患者的健康素养衡量标准。
